Immune responses and associated inflammation in certain parts of the body, including brain, eye, testes, placenta, and fetus, carry a high risk of lethal organ dysfunction or reproductive failure. These tissues, which have evolved to be protected, to a variable degree, from immune responses, are called immune privileged sites. The Nobel laureate immunologist Sir Peter Medawar coined the term immune privilege in the 1940s to describe the lack of immune responses to tissue transplanted into the brain or the anterior chamber of the eye of experimental animals. Foreign antigens that would evoke an immune response in most tissues are often tolerated in these immune privileged sites. The mechanisms underlying immune privilege vary between these tissues and are not fully understood. Some of the mechanisms are similar to mechanisms of regulation in gut and skin discussed earlier in this chapter and mechanisms of self tolerance discussed in Chapter 14. In this section of the chapter, we will discuss some of the distinguishing features of immune privilege in different tissues.
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